MEDICARE: SMAIN SADOK, M.D., S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801114921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMAIN SADOK, M.D., S.C.

Provider Business Mailing Address
First Line	:	6342 S PULASKI RD
Second Line	:	SUITE 1
City	:	CHICAGO
State	:	IL
Zip	:	60629-4706
Country	:	US
Telephone Number	:	773-284-8601
Fax Number	:	773-284-8605

Provider Business Practice Location Address
First Line	:	6342 S PULASKI RD
Second Line	:	SUITE 1
City	:	CHICAGO
State	:	IL
Zip	:	60629-4706
Country	:	US
Telephone Number	:	773-284-8601
Fax Number	:	773-284-8605

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SMAIN SADOK
Credential	:	M.D.
Telephone Number	:	773-284-8601

Provider Enumeration Date	:	05/13/2010
Last Update Date	:	05/13/2010

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Directions to “SMAIN SADOK, M.D., S.C. ” Practice Location

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